Getting to the Root of Eating Disorders

Deep brain stimulation studied as treatment for obesity and anorexia

(RxWiki News) Eating disorders leading to obesity or anorexia are widespread and growing in number. Poor success rates of current treatments have led researchers to look for new therapies.

Currently, medications, diet counseling and surgery are the methods used to treat very obese people. Methods that do not involve surgery have only a small chance of controlling weight for a long period of time.

Surgery in which the stomach is by-passed or reduced in size with staples or bands has been more effective in long-term weight control, but can have serious side effects. People with anorexia have only medications and counseling as treatment options.

Preliminary studies testing a new technique called deep brain stimulation, used successfully to treat people with Parkinson’s disease and obsessive-compulsive disorder, have suggested that this also may be effective in treating eating disorders.

"Seek help if you have an eating disorder."

The lead author of this paper was Alessandra A. Gorgulho, MD, MSc, from the Departments of Neurosurgery and Radiation Oncology in the David Geffen School of Medicine at the University of California, Los Angeles and HCor Neuroscience at Hospital do Coracao in Sao Paulo, Brazil. Dr. Gorgulho and colleagues reported on several studies of deep brain stimulation.

The number of people who are considered very obese has doubled in the last 20 years. Extreme obesity is linked to many serious health problems, such as high blood pressure, heart troubles, stroke, diabetes, arthritis, infertility and others.

On the other end of the eating disorder list is anorexia, which is a refusal to maintain normal body weight and usually involves drastic under-eating. Over 20 percent of patients with anorexia get no results from current treatment, and 6-11 percent will die from the disorder.

Deep brain stimulation involves placing a microelectrode into the brain and delivering a small pulse of electricity to that area. This treatment is approved by the US Food and Drug Administration (FDA) to treat the tremor of Parkinson’s disease and for obsessive-compulsive disorder (OCD) that has not been helped with other treatments.

Recent research has shown that different areas of the brain are active in overeating and in anorexia. This finding was an important step toward being able to use deep brain stimulation to treat obesity and anorexia.

Two studies done in 2013 suggested that deep brain stimulation may benefit people with anorexia.

In both of these 2013 studies, women were the research participants and the researchers measured body mass as an indicator of how the treatment worked. An increase in body mass would suggest that the women were gaining weight, an important goal in anorexia treatment.

In one these studies, led by Nir Lipsman, MD, three of the six women implanted with the microprobe had a body mass increase after nine months.

The other study, which was led by Hongzhi Wu, PhD, involved four women. After 38 months, these women had a 65 percent increase in body mass.

Research on the part of the brain that is affected in Parkinson's disease has provided information that may prove useful in the treatment of severe obesity. This part of the brain is called the dopaminergic system.

Now that this part of the brain has been identified, scientists believe that by targeting this area with deep brain stimulation they will be able to turn off the signal to overeat. It is anticipated that deep brain stimulation may be able to be performed easily on severely overweight people.

A limitation of the two anorexia studies was that they were done only on women, so the techniques also need to be tested in men. The number of participants in these studies was too small to definitively show that they were real and significant; therefore, the results can only be called observations, not conclusions. There are five experimental research studies in progress currently — two on deep brain stimulation for obesity and three for anorexia.

Information presented here was taken from a scientific paper published in the January edition of Neurosurgery Clinics of North America.

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